Objective. To describe parents' opinions and concerns about antibiotic
s and to contrast these opinions with those of pediatricians. Design.
Parents were surveyed using an interviewer-administered questionnaire
and pediatricians were mailed a self-administered questionnaire. Resul
ts. Parents from two private practices (N = 300) were largely white (8
4%) and had completed college (81%). The parents from a community heal
th center (N = 100) were mostly black (80%) and had not completed coll
ege (91%). Twenty-nine percent of parents were worried that their chil
dren were receiving too many antibiotics. Eighty-five percent believed
there were problems with receiving too many antibiotics, with 55% men
tioning resistance or immunity as concerns. Eighteen percent of parent
s had given their child an antibiotic at home before consulting a phys
ician. Parents believed that antibiotics were always or sometimes requ
ired for ear infections (93%), throat infections (83%), colds (32%), c
ough (58%), and fever (58%). Fourteen percent of parents believed that
their child had required an antibiotic when the doctor did not prescr
ibe one, with clinic parents significantly more likely to report this
issue (22%) than private practice parents (12%). Nine percent believed
that their doctor had prescribed an antibiotic unnecessarily (private
practice = 12%, community health center = 3%). Parents from the priva
te practices were also more likely to report requesting a specific ant
ibiotic (34%) in comparison with 19% of clinic parents. Sixty-one perc
ent of the physician surveys were returned after two mailings and a fo
llow-up phone call. The pediatricians had been in practice for a media
n of 12 years, seeing a median of 110 patients per week. Fifty-eight p
ercent of pediatricians reported that some, many, or most of the paren
ts in their practices were worried that their children were receiving
too many antibiotics. Seventy-one percent indicated that four or more
times during the previous month, a parent had requested an antibiotic
when the physician believed it was unnecessary, and 35% said that at l
east occasionally they went along with these requests. Sixty-one perce
nt reported that parents requested a different antibiotic from the one
they were going to prescribe at least four times in the previous mont
h, and 30% of pediatricians said that they agreed to parents' requests
often or most of the time. Conclusions. Both the parent and the physi
cian surveys suggest that parents are concerned about the overuse of a
ntibiotics, but often request them when their physicians believe they
are unnecessary. Parents often administer antibiotics without physicia
n knowledge, and many parents have misconceptions about which illnesse
s warrant antibiotic therapy. Understanding parents' concerns and beli
efs about antibiotics and the range of physician practice styles with
respect to antibiotics may direct the development of intervention stra
tegies to reduce the inappropriate use of oral antibiotics.